26. Sleep Initiation Difficulties Identify Sex-Specific Risk for Persisting Symptoms Following Pediatric Concussion
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ID: 324491
2026
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Abstract
Abstract Purpose Sleep-related complaints are common following pediatric concussion but remain understudied as predictors of recovery. This study examined sex-specific associations between sleep symptoms and risk for persisting symptoms after concussion (PSaC: ≥ 28 days) in youth ages 6-18. Method This retrospective cohort study analyzed 1,731 youth with sport and recreation related concussion; 208 were excluded for missing data. Participants were evaluated within 14 days of injury. The primary outcome was PSaC. Predictors included sex and PCSS-reported difficulty falling asleep and sleeping too much. Results Among 1,517 youth, 12.5% demonstrated PSaC. Male sex was associated with lower odds of PSaC compared with female sex (OR=0.39, 95% CI [0.28–0.53], p<.001). The interaction between sex and difficulty falling asleep was significant (OR=2.22, 95% CI [1.72–2.86], p<.001), whereas the interaction between sex and sleeping too much was not (p=.341). Model discrimination was modest (AUC=.667, 95% CI [.624– .710]). Using a sensitivity-prioritized probability threshold (≈0.15), sensitivity was 64.7% and specificity was 64.1%. Observed PSaC rates were 20.5% in the predicted high-risk group versus 7.3% in the low-risk group (χ2=57.62, p<.001). Conclusions Early sleep initiation difficulties demonstrate sex-specific associations with prolonged recovery in pediatric concussion. Screening for sleep complaints during initial evaluation may support early risk stratification and closer clinical monitoring.
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| Authors | A Salman, J Fox, S Irani, H Howard, P Mularoni, D Ransom |
| Journal | archives of clinical neuropsychology : the official journal of the national academy of neuropsychologists |
| Year | 2026 |
| DOI |
10.1093/arclin/acag055.026
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| URL | |
| Keywords | Keywords not found |
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